Provider First Line Business Practice Location Address:
1035 PLACER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-248-3711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2023